Bladder Cancer

Definition

The bladder is located in the lower abdomen. It is a hollow organ with flexible muscular walls. It stores urine until a person is ready to urinate. Bladder cancer is a disease in which cancer cells grow in the bladder.

Cancer occurs when cells in the body, in this case bladder cells, divide without control or order. Sometimes, cells divide uncontrollably when new cells are not needed. A mass of tissue called a growth or tumor can form. The term cancer refers to malignant tumors. Malignant tumors can invade nearby tissue and spread to other parts of the body.

Three main types of cancer affect the bladder. They are named for the type of cell that becomes cancerous:

Causes

The cause of bladder cancer is unknown. However, several risk factors have been identified.

Risk Factors

This condition is more common in adults between 65 and 85 years old. It is also more common in men and people who are Caucasian. Factors that may increase your chance of developing bladder cancer include:

Bladder diverticuli: an area of weakness in the bladder wall through which some of the lining of the bladder is forced out

Metastasis from another cancer

Symptoms

Symptoms include:

Blood in the urine

Frequent urination, or feeling the need to urinate without being able

Painful urination

Lower back pain

Weight loss, bone pain, or abdominal pain in advanced cases

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor will feel the abdomen and pelvis for abnormalities. The physical exam may include a rectal or vaginal exam.

Your urine may need to be examined. This can be done with:

Urine cytology

Urine culture

Your bladder and the surrounding area may need to be viewed. This can be done with:

A sample of bladder tissue may need to be tested. This can be done with a biopsy.

Staging tests are done after bladder cancer is found. These tests find out if the cancer has spread and, if so, to what parts of the body. Treatments for bladder cancer depend on the stage of the cancer. The stages of bladder cancer are:

Stage 0: cancer cells are found only on the surface of the inner lining of the bladder

Stage 1: cancer cells are found deep in the inner lining of the bladder; no lymph nodes are involved

Stage 2: cancer cells have spread to the muscle of the bladder; no lymph nodes are involved

Stage 3: cancer cells have spread through the muscular wall of the bladder to the layer of tissue surrounding the bladder
OR
possibly to the reproductive organs including the prostate glands; no lymph nodes are involved

Stage 4: cancer cells extending outside the bladder to the wall of the abdomen or to the wall of the pelvis without lymph node involvement
OR
have spread to one or more lymph nodes and other parts of the body

Treatment

Treatment options depend on the stage and may include one of more of:

Surgery

Transurethral resection—This is done for early stage or superficial bladder cancer. A cystoscope is placed into the bladder through the urethra. A small wire loop at the end of the cystoscope is used to remove cancer cells. Fulguration can be done during this procedure. It uses electrical current to burn away remaining cancer cells.

Cystectomy
is the surgical removal of all or part of the bladder—This is done when bladder cancer is invasive. Segmental or partial cystectomy is the removal of part of the bladder. Radical cystectomy is the removal of the entire bladder and nearby lymph nodes. In men, the prostate is usually also removed. In women, the uterus, ovaries, part of the vagina, and the fallopian tubes might also be removed. A form of urinary diversion must be created to store the urine if the bladder is removed.

Radiation Therapy

Radiation Therapy
is the use of radiation to kill cancer cells and shrink tumors. Radiation may be:

External radiation therapy—Radiation is directed at the tumor from a source outside the body.

Internal radiation therapy—Radioactive materials are placed near the cancer cells in the bladder through the urethra or through an incision in the abdomen.

Chemotherapy

Chemotherapy
is the use of drugs to kill cancer cells. Chemotherapy may be given in many forms, including pill, injection, or via a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells. For bladder cancer, chemotherapy is often given directly into the bladder. This is called intravesical chemotherapy.

Biologic Therapy (Immunotherapy)

Biologic therapy is the use of the body’s immune system to fight cancer. Substances made by the body or in a laboratory are given directly into the bladder to help boost, direct, or restore the body’s defenses against the cancer.
This type of therapy is used only for superficial low-grade cancers that have been resected transurethrally.

Prevention

The following steps can reduce your risk of getting bladder cancer:

If you
smoke
or use tobacco products, talk to your doctor about ways to quit.

Avoid or minimize occupational exposure to certain chemicals; follow good work safety practices.

Eat a diet rich in fruits and vegetables.

Avoid excess intake of high fat or high cholesterol foods.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.